孟鲁司特钠联合吸入性布地奈德对哮喘儿童小气道功能和呼出气一氧化氮浓度的影响

Effects of montelukast sodium combined with inhaled budesonide on small airway function and fractional exhaled nitric oxide concentration in children with asthma

目的 评价孟鲁司特钠联合吸入性布地奈德治疗儿童哮喘的临床疗效及其对小气道功能和呼出气一氧化氮(FeNO)浓度的影响。方法 前瞻性选择典型哮喘儿童132例为研究对象,随机分为对照组和观察组,每组66例。对照组采用吸入性布地奈德混悬液,观察组在对照组基础上联合应用孟鲁司特钠颗粒,2组均连续应用4周。分析2组临床疗效、不良反应、大气道肺功能和小气道功能以及FeNO浓度;比较2组随访1年哮喘复发率。结果 对照组63例和观察组64例最终完成随访。观察组临床总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前和治疗后,2组大气道肺功能相关指标比较,差异均无统计学意义(P>0.05)。治疗4周后,2组最大呼气中期流速(MMEF)、呼气流量峰值(PEF)和50%肺活量时最大呼气流速(MEF_(50))均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);2组FeNO浓度均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。随访发现,观察组复发率低于对照组,差异有统计学意义(P<0.05)。结论 孟鲁司特钠联合吸入性布地奈德治疗儿童哮喘有较好的安全性和有效性,可进一步改善小气道功能,降低FeNO浓度。

Objective To evaluate the clinical efficacy of montelukast sodium combined with inhaled budesonide in treatment of children with asthma, and the effects on small airway function and fractional exhaled nitric oxide(FeNO) concentration. Methods A total of 132 children with typical asthma were prospectively selected as the research objects. They were randomly divided into control group and observation group, with 66 cases in each group. The control group was treated with inhaled budesonide suspension, while the observation group was treated with montelukast sodium granules on the basis of the control group. Both groups were treated for 4 weeks continuously. Clinical efficacy, adverse reactions, pulmonary function and small airway function and FeNO concentration of the two groups were analyzed. The two groups were followed up for one year to compare the recurrence rate of asthma. Results A total of 63 cases in control group and 64 cases in observation group finally completed the follow-up. The total clinical effective rate in observation group was significantly higher than that in control group(P< 0.05). Before and after treatment, there was no significant difference in related indexes of pulmonary function in the two groups(P>0.05). After 4 weeks of treatment, maximum mid expiratory flow rate(MMEF), peak expiratory flow rate(PEF) and maximum expiratory flow rate at 50% vital capacity(MEF_(50)) in the two groups were all statistically higher than before, and the observation group was statistically higher than the control group(P< 0.05);the concentration of FeNO in the two groups were significantly lower than before, and the observation group was significantly lower than the control group( P < 0. 05). Follow-up showed that the recurrence rate of observation group was significantly lower than that of the control group( P < 0. 05). Conclusion Montelukast sodium combined with inhaled budesonide has higher safety and efficacy in the treatment of children with asthma,which can further improve small airway function and reduce FeNO concentration.